Oncology (General Cancer)/breast cancer

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Question
Hello Doctor, this is  a question you probably don't get that often.  I was reading about a woman named Jill, I believed it's  story being followed in USA today She  has had breast cancer for quite awhile, she is now in very bad condition.  she has described what a horrible existence she's in now, it has spread, they put in a pain pump, had to remove it because of some sort of complication, she's in pain, she's hospitalized almost more than being home.  She has described what appears to be nothing but suffering.  I was with a group of people and we started discussing this person.  everyone unanimously agreed that in the 21st century 2015, people should not be suffering the way she describes. She has some women scared to death, and aren't looking forward to seeing doctors.  It's inexplicable to me that doctors would allow such suffering, we all thought we hear so much about making strides in this disease.  We don't see it, and now reading about this woman living in nothing but pain and discomfort is horrible.  People were treated better for pain, in the early part of the century.  Can't someone in her condition be put into a coma or some sort of pain free existence, we just can't believe one is allowed to suffer this way. thank you for your thoughts.  I hope we hear this is not the case any longer.

Answer
During my years as a cancer specialist, I've had three patients in whom I could not relieve their pain. Having kept up with the science of pain medicine, I think I can look back and say that if I were taking care of them today with what I know now and what is available, I could relieve their pain.  That being said, I'm very aware of patients who doctors have given up on, or who are being managed by physicians who are being motivated by fear of narcotics rather than relief of suffering.  If someone is having intractable pain and their doctor isn't doing anything about it, it's time to get another doctor.  And yes, as a last resort, I think it's acceptable to use medications to basically put a patient to sleep.  I've done this temporarily.  Sometimes getting a good drug induced sleep helps with pain management afterward.  
I am opposed to physician assisted suicide. My reasons are based on science.  The pressure to relieve suffering is the main reason for innovation in medicine.  If we decide to relieve suffering by killing the one who is suffering, that greatly decreases the pressure to develop ways to deal with pain and suffering.  
It's analogous to the situation with Down's syndrome.  When children were born with this, society and science developed methods for helping patients and families with this illness.  Gradually Down's children began to live longer and accomplish more.  We've read about a young lady who is a model; a few years ago there was a Down's who acted in a TV series.  In our town there is a young man who recently graduated from college  -- with Downs.  But now most children with Down's are aborted because we can predict who will have it.  And there is much less pressure to do something for Down's children.  

Oncology (General Cancer)

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Donald Higby, M.D.

Expertise

I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.

Experience

I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

Organizations
American Society of Clinical Oncology

Publications
New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

Education/Credentials
MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

Awards and Honors
America's Best Physicians, last 14 years

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